Health Care

Trump health official meets with doctors pushing herd immunity

Bonnie Cash

A top Trump health official met Monday with a group of doctors who are proponents of the controversial “herd immunity” approach to COVID-19, even as other experts warn of its deadly and dangerous consequences.

Martin Kulldorff, a professor at Harvard; Sunetra Gupta, a professor at Oxford; and Jay Bhattacharya, a professor at Stanford, all of whom are epidemiologists studying infectious diseases, were invited to the meeting by Health and Human Services Secretary Alex Azar and Scott Atlas, an adviser to Trump on whom other experts have cast doubt for his statements about COVID-19, including his endorsement of herd immunity. 

In the meeting, the three doctors told Azar that allowing the virus to spread uncontrolled among young, healthy people while protecting older adults and those at higher risk for serious illness would build up enough population immunity to stop it from spreading widely while avoiding lockdowns and other mitigation measures that have had a damaging impact on the economy. 

“We had a very good discussion. He asked many questions, and we put forth our case to protect the people who are vulnerable, and the idea of trying to do lockdowns to eliminate this disease is not realistic,” Kulldorff said. 

Other experts argue that allowing COVID-19 to spread uncontrollably would lead to unnecessary deaths, illness and hospitalizations, even if the U.S. attempted to isolate vulnerable people from the rest of the population while the virus spreads.  

Herd immunity is typically accomplished when enough people are vaccinated against a virus, but a vaccine has not yet been approved for COVID-19. 

The idea of allowing the virus to spread uncontrollably is gaining traction in the White House, where Atlas is advising President Trump, who is battling his own case of COVID-19.

Atlas told The Hill in an email that he attended the meeting and supports the declaration the group put out endorsing herd immunity. 

“Their targeted protection of the vulnerable and opening schools and society policy matches the policy of the President and what I have advised,” he wrote.

After this story was published, Bhattacharya, the Stanford professor, said it was “false” to say the group was pushing a herd immunity strategy. 

“A herd immunity strategy better describes the current lockdown policy,” he said in an email. “Herd immunity is a biological fact so of course we mention it, but it is not our strategy.”

The Great Barrington declaration signed by the doctors argues that the lockdown policies “are producing devastating effects on short and long-term public health,” including fewer cancer screenings, lower childhood vaccination rates and deteriorating mental health.

It said keeping restrictions in place until a vaccine is available will cause damage, and makes the case for allowing young people to get the coronavirus while shielding the vulnerable from it so that herd immunity is built up without a vaccine. The group calls this “focused protection.”

“The most compassionate approach that balances the risks and benefits of reaching herd immunity, is to allow those who are at minimal risk of death to live their lives normally to build up immunity to the virus through natural infection, while better protecting those who are at highest risk,” the declaration reads. “We call this Focused Protection.”

The declaration calls for schools and universities to be opened for in-person teaching with sports and other extracurricular activities resumed. Young adults should work normally and not at home, it says, with restaurants and other businesses opened.

William Hanage, an associate professor of epidemiology at Harvard who noted that most experts are not pushing for continuous lockdowns everywhere all the time, agreed that a better job needs to be done of handling the unintended economic and social consequences of public health measures but argued that speeding up herd immunity without a vaccine is not the answer and could also overwhelm hospitals. 

“It’s quite dangerous, for multiple reasons,” he said.

“If you do this, you’ll get more infections, more hospitalizations and more deaths,” he added.

The mainstream view of epidemiologists and public health experts, including the nation’s top infectious disease expert Anthony Fauci and the World Health Organization, is that the best way to get through COVID-19 and protect people who are at risk for serious illness is to not get sick in the first place by wearing masks and practicing social distancing. 

While young people are far less likely to become seriously ill or die from COVID-19, they’re still capable of spreading the disease to people who will become very sick or die. 

But the experts who met with Azar argued that living with those public health measures for the next several months until a vaccine is available is not feasible, given the unintended consequences for mental health, missed childhood vaccinations and the economy.

Allowing schools and businesses to reopen and letting people return to work and go about their normal lives could build up herd immunity to a point where those public health measures aren’t necessary, they wrote in their declaration. 

“The alternative [to herd immunity], which is to keep suppressing the virus, comes at an enormous cost to the poor and to the young and not just in this country but worldwide,” Gupta said. 

Letting the virus spread uncontrolled among people who are least likely to become seriously ill from it will create enough herd immunity to protect the vulnerable by December, Gupta and the others argued. 

In the meantime, the government could provide housing to vulnerable people who live in multigenerational homes, where younger people may bring the virus home, Bhattacharya said. 

“We could do policies that would make those resources available to older people in multigenerational settings for the limited period of time that’s necessary until the disease is under control, and after time, they could go back home,” Bhattacharya said. 

People living in nursing homes, which have been ravaged by COVID-19, especially in the early days of the pandemic, could be protected with regular testing of staff and visitors, he said. 

However, Hanage questioned the ability to successfully cordon off the most vulnerable and protect them from getting infected, noting that the White House recently became the site of a superspreading event involving the president, despite having regular access to testing that the average American does not. 

“The greatest risk of introduction to the most vulnerable communities will be when the rate of infection is really high in younger age groups,” Hanage said.

“How would you keep the virus out if 10 percent of the younger population is infected at peak prevalence and with tests that cannot keep the virus out of the White House?” he added.

He also argued that the vulnerable population would still be at risk when it returns home, even if the virus is spreading at a lower prevalence. 

“We tend to make contacts with people around our own age, and given that none of the older generations would have immunity, they’d be in contact networks at risk of devastating outbreaks,” he said. 

Questions also remain about how long immunity from COVID-19 lasts after infection and whether people can become sick more than once. It’s also not known what percentage of the population needs to be infected with COVID-19 before herd immunity is accomplished.

Gregg Gonsalves, an assistant professor of epidemiology at Yale School of Medicine, tweeted in response to the declaration that a large number of people vulnerable to severe COVID-19 illness don’t live in nursing homes, including 50 percent of all Americans who have some sort of underlying health condition. He added that surges in cases among young people have already likely led to deaths of older, more vulnerable people, despite efforts to protect them. 

“If you’re going to turbo-charge community spread, as everyone else at ‘low-risk’ goes about their business, I want the plan for my 86-year-old mother to be more than theoretical,” he said. 

The concept of herd immunity has been discussed frequently on Fox News and is endorsed by conservative groups and commentators who want to see the economy fully reopen. 

Trump has recently started talking about the concept of herd immunity, erroneously calling it “herd mentality” in a recent interview. 

However, Azar told lawmakers last week during a hearing that “herd immunity is not the strategy of the U.S. government.” 

“We may get herd slowing of transmission as we perhaps have seen in the New York area and other concentrated areas. Our mission is to reduce fatalities, protect the vulnerable, keep coronavirus cases down to the lowest level possible,” he said.

He tweeted Monday evening he met with the experts “as part of our commitment to ensure we hear broad and diverse scientific perspectives.” 

“We heard strong reinforcement of the Trump Administration’s strategy of aggressively protecting the vulnerable while opening schools and the workplace,” he added.

This story was updated at 10:59 a.m.

Tags Anthony Fauci Coronavirus COVID-19 Donald Trump herd immunity

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